Damping a telesurgical system

ABSTRACT

Methods and systems for damping vibrations in a surgical system are disclosed herein. The damping of these vibrations can increase the precision of surgery performed using the surgical system. The surgical system can include one or several moveable set-up linkages. A damper can be connected with one or several of the set-up linkages. The damper can be a passive damper and can mitigate a vibration arising in one or more of the set-up linkages. The damper can additionally prevent a vibration arising in one of the linkages from affecting another of the set-up linkages.

RELATED APPLICATIONS

This patent application claims priority to and the benefit of the filingdate of U.S. Provisional Patent Application 62/032,485, entitled“DAMPING A TELESURGICAL SYSTEM,” filed Aug. 1, 2014, which isincorporated by reference herein in its entirety.

BACKGROUND

Minimally invasive medical techniques are intended to reduce the amountof extraneous tissue that is damaged during diagnostic or surgicalprocedures, thereby reducing patient recovery time, discomfort, anddeleterious side effects. One effect of minimally invasive surgery, forexample, is reduced post-operative hospital recovery times. Because theaverage hospital stay for a standard surgery is typically significantlylonger than the average stay for an analogous minimally invasivesurgery, increased use of minimally invasive techniques could savemillions of dollars in hospital costs each year. While many of thesurgeries performed each year in the United States could potentially beperformed in a minimally invasive manner, only a portion of the currentsurgeries use these advantageous techniques due to limitations inminimally invasive surgical instruments and the additional surgicaltraining involved in mastering them.

Minimally invasive teleoperated robotic surgical or telesurgical systemshave been developed to increase a surgeon's dexterity and avoid some ofthe limitations on traditional minimally invasive techniques. Intelesurgery, the surgeon uses some form of remote control (e.g., aservomechanism or the like) and computer assistance to manipulatesurgical instrument movements, rather than directly holding and movingthe instruments by hand. In telesurgery systems, the surgeon can beprovided with an image of the surgical site at a surgical workstation.While viewing a two or three dimensional image of the surgical site on adisplay, the surgeon performs the surgical procedures on the patient bymanipulating master control devices, which in turn control motion of theslave servo-mechanically operated instruments.

The servomechanism system used for telesurgery will often accept inputfrom two master controllers (one for each of the surgeon's hands) andmay include two or more robotic arms on each of which a surgicalinstrument is mounted. Operative communication between mastercontrollers and associated robotic arm and instrument assemblies istypically achieved through a control system. The control systemtypically includes at least one processor that relays input commandsfrom the master controllers to the associated robotic arm and instrumentassemblies and back from the instrument and arm assemblies to theassociated master controllers in the case of, for example, forcefeedback or the like. One example of a teleoperated robotic surgicalsystem is the DA VINCI® Surgical System commercialized by IntuitiveSurgical, Inc. of Sunnyvale, Calif.

A variety of structural arrangements can be used to support the surgicalinstrument at the surgical site during robotic surgery. The drivenlinkage or “slave” is often called a robotic surgical manipulator, andexemplary linkage arrangements for use as a robotic surgical manipulatorduring minimally invasive robotic surgery are described in U.S. Pat.Nos. 7,594,912; 6,758,843; 6,246,200; and 5,800,423; the fulldisclosures of which are incorporated herein by reference. Theselinkages often make use of a parallelogram arrangement to hold aninstrument having a shaft. Such a manipulator structure can constrainmovement of the instrument so that the instrument pivots about a remotecenter of manipulation positioned in space along the length of the rigidshaft. By aligning the remote center of manipulation with the incisionpoint to the internal surgical site (for example, with a trocar orcannula at an abdominal wall during laparoscopic surgery), an endeffector of the surgical instrument can be positioned safely by movingthe proximal end of the shaft using the manipulator linkage withoutimposing potentially dangerous forces against the abdominal wall.Alternative manipulator structures are described, for example, in U.S.Pat. Nos. 7,763,015; 6,702,805; 6,676,669; 5,855,583; 5,808,665;5,445,166; and 5,184,601; the full disclosures of which are incorporatedherein by reference.

A variety of structural arrangements can also be used to support andposition the robotic surgical manipulator and the surgical instrument atthe surgical site during robotic surgery. Supporting linkage mechanisms,sometimes referred to as set-up joints, or set-up joint arms, are oftenused to position and align each manipulator with the respective incisionpoint in a patient's body. The supporting linkage mechanism facilitatesthe alignment of a surgical manipulator with a desired surgical incisionpoint and targeted anatomy. Exemplary supporting linkage mechanisms aredescribed in U.S. Pat. Nos. 6,246,200 and 6,788,018, the fulldisclosures of which are incorporated herein by reference.

While the new telesurgical systems and devices have proven highlyeffective and advantageous, still further improvements are desirable. Ingeneral, improved minimally invasive robotic surgery systems aredesirable. It would be particularly beneficial if these improvedtechnologies enhanced the efficiency and ease of use of robotic surgicalsystems. For example, it would be particularly beneficial to increasemaneuverability, improve space utilization in an operating room, providea faster and easier set-up, inhibit collisions between robotic devicesduring use, and/or reduce the mechanical complexity and size of thesenew surgical systems.

BRIEF SUMMARY

The following presents a simplified summary of some embodiments of theinvention in order to provide a basic understanding of the invention.This summary is not an extensive overview of the invention. It is notintended to identify key/critical elements of the invention or todelineate the scope of the invention. Its sole purpose is to presentsome embodiments of the invention in a simplified form as a prelude tothe more detailed description that is presented later.

One aspect of the present disclosure relates to a damped surgicalsystem. The damped surgical system includes a base, a surgical tool, anda linkage supporting the surgical tool relative to the base, the linkageincluding a series of arms with a plurality of joints disposed betweenadjacent arms so that commanded movements of the surgical tool relativeto the base are effected by articulation of the joints. In someembodiments, one of the joints includes a first arm portion connected tothe base, a second arm portion having a first end connected to the basevia the first arm portion and a second end connected to the surgicaltool, and a damper positioned between the first arm portion and a secondarm portion.

In some embodiments, the damper includes a spring element and a dampingelement. In some embodiments, the damper includes a damping platformhaving 3 degrees of freedom. In some embodiments, the damping platformincludes a top plate and a bottom plate connected by a flexure, whichcan be an axial flexure, and a plurality of dampers radially positionedaround the flexure. In some embodiments, the flexure includes a constantradius between the portion of the flexure connecting to the top plateand the portion of the flexure connecting to the bottom plate. In someembodiments, the flexure includes a non-constant radius between theportion of the flexure connecting to the top plate and the portion ofthe flexure connecting to the bottom plate. In some embodiments, theradius of the portion of the flexure connecting to the top plate islarger than the radius of the portion of the flexure connecting to thebottom plate. In some embodiments, the top plate and the bottom plate ofthe damping platform are connected by a radial flexure including amiddle plate and a plurality of vertical walls extending from the middleplate to the top plate.

In some embodiments, the damped surgical system includes a decouplingflexure between the flexure and the radial flexure. In some embodiments,the damping platform includes a top plate and a bottom plate connectedby a shaft cantilevered to the bottom plate and connected to the topplate via a ball pivot. In some embodiments, the damping platformfurther includes a plurality of dampers radially positioned around theshaft. In some embodiments, at least one of the plurality of dampers ispaired with a spring. In some embodiments, at least one of the pluralityof dampers includes a coil-over damper.

One aspect of the present disclosure relates to a damped robotic surgerysystem. The damped robotic surgery system includes a base, a first armportion connected to the base, a second arm portion having a first endconnected to the base via the first arm portion and a second endconnected to a surgical tool, and a squeeze film damper positionedbetween the first arm portion and a second arm portion.

In some embodiments, the squeeze film damper includes a cup and aninsert, and a damping fluid between the cup and the insert. In someembodiments, the cup includes a plurality of inwardly extending ridgesand the insert comprises a plurality of outwardly extending ridges. Insome embodiments, the plurality of inwardly extending ridges areinterdigitated with the plurality of outwardly extending ridges.

In some embodiments, the squeeze film damper has 3 degrees of freedom.In some embodiments, the patient side cart includes a plurality ofrobotic mechanisms.

One aspect of the present disclosure relates to a method of controllinga position of a second arm during surgery. The method includespositioning a robotic linkage base adjacent to a patient for a surgicalproceeding, positioning a first surgical tool proximate to the patent,the first surgical tool supported relative to the base by a first arm,positioning a second surgical tool proximate to the patient, whichsecond surgical tool is supported relative to the base by a second armand the first and second arm are mechanically connected via a damper,directing the movement of the first arm, which movement of the first armcreates vibrations, and dissipating the created vibrations at the damperso as to inhibit uncommanded movement of the second tool.

In some embodiments, the first arm includes a first arm portionconnected to the patient side cart, and a second arm portion having afirst end connected to the patient side cart via the first arm portionand a second end connected to a surgical tool. In some embodiments, thedamper is positioned between the first arm portion and the second armportion. In some embodiments, the damper dissipates the createdvibrations such that the second end of the second arm portion does notvibrate.

In some embodiments, the damper includes a damping platform having a topplate and a bottom plate connected by a flexure, which can be, forexample, an axial flexure, and a plurality of dampers radiallypositioned around the flexure. In some embodiments, the flexure includesa constant radius between the portion of the flexure connecting to thetop plate and the portion of the flexure connecting to the bottom plate.In some embodiments, the flexure includes a non-constant radius betweenthe portion of the flexure connecting to the top plate and the portionof the flexure connecting to the bottom plate. In some embodiments, theradius of the portion of the flexure connecting to the top plate islarger than the radius of the portion of the flexure connecting to thebottom plate. In some embodiments, the top plate and the bottom plate ofthe damping platform are connected by a radial flexure including amiddle plate and a plurality of vertical walls extending from the middleplate to the top plate. In some embodiments of the method, the damperincludes a decoupling flexure between the flexure and the radialflexure. In some embodiments, the damping platform includes a top plateand a bottom plate connected by a shaft cantilevered to the bottom plateand connected to the top plate via a ball pivot. In some embodiments,the damping platform includes a plurality dampers radially positionedaround the shaft. In some embodiments, at least one of the plurality ofdampers is paired with a spring, and in some embodiments, at least oneof the plurality of dampers includes a coil-over damper.

For a fuller understanding of the nature and advantages of the presentinvention, reference should be made to the ensuing detailed descriptionand accompanying drawings. Other aspects, objects and advantages of theinvention will be apparent from the drawings and detailed descriptionthat follows.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a plan view of a minimally invasive robotic surgery systembeing used to perform a surgery, in accordance with many embodiments.

FIG. 2 is a perspective view of a surgeon's control console for arobotic surgery system, in accordance with many embodiments.

FIG. 3 is a perspective view of a robotic surgery system electronicscart, in accordance with many embodiments.

FIG. 4 diagrammatically illustrates a robotic surgery system, inaccordance with many embodiments.

FIG. 5A is a partial view of a patient side cart (surgical robot) of arobotic surgery system, in accordance with many embodiments.

FIG. 5B is a front view of a robotic surgery tool, in accordance withmany embodiments.

FIG. 6 shows a robotic surgery system, in accordance with manyembodiments.

FIG. 7 illustrates rotational orientation limits of set-up linkagesrelative to an orienting platform of the robotic surgery system of FIG.6.

FIG. 8 shows a center of gravity diagram associated with a rotationallimit of the boom assembly for a robotic surgery system, in accordancewith many embodiments.

FIG. 9 shows a remote center manipulator, in accordance with manyembodiments, that includes a curved feature having a constant radius ofcurvature relative to the remote center of manipulation and along whicha base link of the outboard linkage can be repositioned.

FIG. 10 shows a remote center manipulator, in accordance with manyembodiments, that includes a closed-loop curved feature to which a baselink of the outboard linkage is interfaced such that the base link isconstrained to move along the closed-loop curved feature.

FIG. 11 is a side view of the remote center manipulator in aconfiguration of maximum pitch back of the instrument holder relative tothe remote center of manipulation, in accordance with many embodiments.

FIG. 12 is a perspective view of one embodiment of a portion of therobotic surgery system.

FIG. 13 is a section view of one embodiment of portions of the set-uplinkage.

FIG. 14 is a perspective view of one embodiment of a damper for use withthe robotic surgery system.

FIG. 15 is a perspective view of an alternative embodiment of a damperfor use with the robotic surgery system.

FIG. 16 is a perspective view of another alternative embodiment of adamper for use with the robotic surgery system.

FIG. 17 is a perspective view of another alternative embodiment of adamper for use with the robotic surgery system.

FIG. 18 is a section view of one embodiment of a squeeze film damper foruse with the robotic surgery system.

DETAILED DESCRIPTION

In the following description, various embodiments of the presentinvention will be described. For purposes of explanation, specificconfigurations and details are set forth in order to provide a thoroughunderstanding of the embodiments. However, it will also be apparent toone skilled in the art that the present invention may be practicedwithout the specific details. Furthermore, well-known features may beomitted or simplified in order not to obscure the embodiment beingdescribed.

The kinematic linkage structures and control systems described hereinare particularly beneficial in helping system users to arrange therobotic structure of a procedure on a particular patient. The damping ofthese kinematic linkage structures can increase the control a surgeonhas over movement of one or several surgical tools, and thus can allow amore precise surgery. In this description, actively driven, or active,means a motor assists motion of a joint, and passive means a joint mustbe moved in some way from outside the system. Some actively drivenjoints are teleoperated, such as joints in a teleoperated surgicalinstrument manipulator under a surgeon's control. Other actively drivenjoints are not teleoperated, such as joints operated by a switch nearthe joint or that are associated with an automatic function such ascompensating for gravity effects on a kinematic chain to make the end ofthe chain appear weightless at various changing poses. Along withactively driven manipulators used to interact with tissues and the likeduring treatment, robotic surgical systems may have one or morekinematic linkage systems that are configured to support and help alignthe manipulator structure with the surgical work site. These set-upsystems may be actively driven or may be passive, so that they aremanually articulated and then locked into the desired configurationwhile the manipulator is used therapeutically and/or operatively. Thepassive set-up kinematic systems may have advantages in size, weight,complexity, and cost. However, a plurality of manipulators may be usedto treat tissues of each patient, and the manipulators may eachindependently benefit from accurate positioning so as to allow theinstrument supported by that instrument to have the desired motionthroughout the workspace. Minor changes in the relative locations ofadjacent manipulators may have significant impact on the interactionsbetween manipulators (for example, they may collide with each other, orthe rigidity of the kinematics of the pose may be low enough to resultin large structural vibrations). Hence, the challenges of optimallyarranging the robotic system in preparation for surgery can besignificant.

One option is to mount multiple manipulators to a single platform, withthe manipulator-supporting platform sometimes being referred to as anorienting platform. The orienting platform can be supported by anactively driven support linkage (sometimes referred to herein as aset-up structure, and typically having a set-up structure linkage,etc.). The system may also provide and control motorized axes of therobotic set-up structure supporting the orienting platform with somekind of joystick or set of buttons that would allow the user to activelydrive those axes as desired in an independent fashion. This approach,while useful in some situations, may suffer from some disadvantages.Firstly, users not sufficiently familiar with robotics, kinematics,range of motion limitations and manipulator-to-manipulator collisionsmay find it difficult to know where to position the orienting platformin order to achieve a good setup. Secondly, the presence of any passivejoints within the system means that the positioning of the deviceinvolves a combination of manual adjustment (moving the passive degreesof freedom by hand) as well as controlling the active degrees offreedom, which can be a difficult and time-consuming iterative activity.

To maintain the advantages of both manual and actively-drivenpositioning of the robotic manipulators, embodiments of the roboticsystems described herein may employ a set-up mode in which one or morejoints are actively driven in response to manual articulation of one ormore other joints of the kinematic chain. In many embodiments, theactively driven joints will move a platform-supporting linkage structurethat supports multiple manipulators, greatly facilitating thearrangement of the overall system by moving those manipulators as a unitinto an initial orientational and/or positional alignment with theworkspace. Independent positioning of one, some or all of themanipulators supported by the platform can optionally be providedthrough passive set-up joint systems supporting one, some, or all of themanipulators relative to the platform.

Minimally Invasive Robotic Surgery

Referring now to the drawings, in which like reference numeralsrepresent like parts throughout the several views, FIG. 1 is a plan viewillustration of a Minimally Invasive Robotic Surgical (MIRS) system 10,typically used for performing a minimally invasive diagnostic orsurgical procedure on a Patient 12 who is lying down on an Operatingtable 14. The system can include a Surgeon's Console 16 for use by aSurgeon 18 during the procedure. One or more Assistants 20 may alsoparticipate in the procedure. The MIRS system 10 can further include aPatient Side Cart 22 (a teleoperated surgical system that employsrobotic technology—a surgical robot) and an Auxiliary Equipment Cart 24.The Patient Side Cart 22 can manipulate at least one removably coupledtool assembly 26 (hereinafter simply referred to as a “tool”) through aminimally invasive incision in the body of the Patient 12 while theSurgeon 18 views the surgical site through the Console 16. An image ofthe surgical site can be obtained by an endoscope 28, such as astereoscopic endoscope, which can be manipulated by the Patient SideCart 22 to orient the endoscope 28. The Equipment Cart 24 can be used toprocess the images of the surgical site for subsequent display to theSurgeon 18 through the Surgeon's Console 16. The number of surgicaltools 26 used at one time will generally depend on the diagnostic orsurgical procedure and the space constraints within the operating roomamong other factors. If it is necessary to change one or more of thetools 26 being used during a procedure, an Assistant 20 may remove thetool 26 from the Patient Side Cart 22, and replace it with another tool26 from a tray 30 in the operating room.

FIG. 2 is a perspective view of the Surgeon's Console 16. The Surgeon'sConsole 16 includes a left eye display 32 and a right eye display 34 forpresenting the Surgeon 18 with a coordinated stereo view of the surgicalsite that enables depth perception. The Console 16 further includes oneor more input control devices 36, which in turn cause the Patient SideCart 22 (shown in FIG. 1) to manipulate one or more tools. The inputcontrol devices 36 can provide the same degrees of freedom as theirassociated tools 26 (shown in FIG. 1) to provide the Surgeon withtelepresence, or the perception that the input control devices 36 areintegral with the tools 26 so that the Surgeon has a strong sense ofdirectly controlling the tools 26. To this end, position, force, andtactile feedback sensors (not shown) may be employed to transmitposition, force, and tactile sensations from the tools 26 back to theSurgeon's hands through the input control devices 36.

The Surgeon's Console 16 is usually located in the same room as thepatient so that the Surgeon may directly monitor the procedure, bephysically present if necessary, and speak to an Assistant directlyrather than over the telephone or other communication medium. However,the Surgeon can be located in a different room, a completely differentbuilding, or other remote location from the Patient allowing for remotesurgical procedures.

FIG. 3 is a perspective view of the Auxiliary Equipment Cart 24. TheEquipment Cart 24 can be coupled with the endoscope 28 and can include aprocessor to process captured images for subsequent display, such as toa Surgeon on the Surgeon's Console, or on another suitable displaylocated locally and/or remotely. For example, where a stereoscopicendoscope is used, the Equipment Cart 24 can process the captured imagesto present the Surgeon with coordinated stereo images of the surgicalsite. Such coordination can include alignment between the opposingimages and can include adjusting the stereo working distance of thestereoscopic endoscope. As another example, image processing can includethe use of previously determined camera calibration parameters tocompensate for imaging errors of the image capture device, such asoptical aberrations. Equipment cart 24 may include other surgical systemcomponents, such as at least part of a computer control system used tocontrol the system, endoscopic illumination equipment, electrosurgeryequipment, and other medically-related devices.

FIG. 4 diagrammatically illustrates a robotic surgery system 50 (such asMIRS system 10 of FIG. 1). As discussed above, a Surgeon's Console 52(such as Surgeon's Console 16 in FIG. 1) can be used by a Surgeon tocontrol a Patient Side Cart (Surgical Robot) 54 (such as Patent SideCart 22 in FIG. 1) during a minimally invasive procedure. The PatientSide Cart 54 can use an imaging device, such as a stereoscopicendoscope, to capture images of the procedure site and output thecaptured images to an Electronics Cart 56 (such as the Equipment Cart 24in FIG. 1). As discussed above, the Electronics Cart 56 can process thecaptured images in a variety of ways prior to any subsequent display.For example, the Electronics Cart 56 can overlay the captured imageswith a virtual control interface prior to displaying the combined imagesto the Surgeon via the Surgeon's Console 52. The Patient Side Cart 54can output the captured images for processing outside the ElectronicsCart 56. For example, the Patient Side Cart 54 can output the capturedimages to a processor 58, which can be used to process the capturedimages. The images can also be processed by a combination theElectronics Cart 56 and the processor 58, which can be coupled togetherto process the captured images jointly, sequentially, and/orcombinations thereof. One or more separate displays 60 can also becoupled with the processor 58 and/or the Electronics Cart 56 for localand/or remote display of images, such as images of the procedure site,or other related images.

Processor 58 will typically include a combination of hardware andsoftware, with the software comprising tangible media embodying computerreadable code instructions for performing the method steps of thecontrol functionally described herein. The hardware typically includesone or more data processing boards, which may be co-located but willoften have components distributed among the robotic structures describedherein. The software will often comprise a non-volatile media, and couldalso comprise a monolithic code but will more typically comprise anumber of subroutines, optionally running in any of a wide variety ofdistributed data processing architectures.

FIGS. 5A and 5B show a Patient Side Cart 22 and a surgical tool 62,respectively. The surgical tool 62 is an example of the surgical tools26. The Patient Side Cart 22 shown provides for the manipulation ofthree surgical tools 26 and an imaging device 28, such as a stereoscopicendoscope used for the capture of images of the site of the procedure.Manipulation is provided by robotic mechanisms having a number ofrobotic joints. The imaging device 28 and the surgical tools 26 can bepositioned and manipulated through incisions in the patient so that akinematic remote center is maintained at the incision to minimize thesize of the incision. Images of the surgical site can include images ofthe distal ends of the surgical tools 26 when they are positioned withinthe field-of-view of the imaging device 28.

Surgical tools 26 are inserted into the patient by inserting a tubularcannula 64 through a minimally invasive access aperture such as anincision, natural orifice, percutaneous penetration, or the like.Cannula 64 is mounted to the robotic manipulator arm and the shaft ofsurgical tool 26 passes through the lumen of the cannula. Themanipulator arm may transmit signals indicating that the cannula hasbeen mounted thereon.

Robotic Surgery Systems and Modular Manipulator Supports

FIG. 6 is a simplified representation of a robotic surgery system 140,in accordance with many embodiments. The robotic surgery system 140includes a mounting base 72, a support linkage 122, an orientingplatform 124, a plurality of set-up linkages 126 (two shown), and aplurality of surgical instrument manipulators 82. Each of themanipulators 82 is operable to selectively articulate a surgicalinstrument mounted to the manipulator 82 and insertable into a patientalong an insertion axis. Each of the manipulators 82 is attached to andsupported by one of the set-up linkages 126. Each of the set-up linkages126 is rotationally coupled to and supported by the orienting platform124 by a first set-up linkage joint 84. Each of the set-up linkages 126is fixedly attached to and supported by the orienting platform 124. Theorienting platform 124 is rotationally coupled to and supported by thesupport linkage 122. And the support linkage 122 is fixedly attached toand supported by the mounting base 72.

In many embodiments, the mounting base 72 is a movable and floorsupported, thereby enabling selective repositioning of the overallsurgery system 70, for example, within an operating room. The mountingbase 72 can include a steerable wheel assembly and/or any other suitablesupport features that provide for both selective repositioning as wellas selectively preventing movement of the mounting base 72 from aselected position. The mounting base 72 can also have other suitableconfigurations, for example, a ceiling mount, fixed floor/pedestalmount, a wall mount, or an interface configured for being supported byany other suitable mounting surface.

The support linkage 122 is configured to selectively position and orientthe orienting platform 124 relative to the mounting base 72 via relativemovement between links of the support linkage 122 along multiple set-upstructure axes. The support linkage 122 includes a column base 86, atranslatable column member 88, a shoulder joint 90, a boom base member92, a boom first stage member 94, and a wrist joint 98. The column base86 is fixedly attached to the mounting base 72. The translatable columnmember 88 is selectively repositionable relative to the column base 86along a first set-up structure (SUS) axis 142, which is verticallyoriented in many embodiments. In many embodiments, the translatablecolumn member 88 translates relative to the column base 86 along avertically oriented axis. The boom base member 92 is rotationallycoupled to the translatable column member 88 by the shoulder joint 90.The shoulder joint 90 is operable to selectively orient the boom basemember 92 relative to the translatable column member 88 around a secondSUS axis 144, which is vertically oriented in many embodiments. The boomfirst stage member 94 is selectively repositionable relative to the boombase member 92 along a third SUS axis 146, which is horizontallyoriented in many embodiments. Accordingly, the support linkage 122 isoperable to selectively set the distance between the shoulder joint 90and the distal end of the boom first stage member 94. And the wristjoint 98 is operable to selectively orient the orienting platform 124relative to the boom first stage member 94 around a fourth SUS axis 148,which is vertically oriented in many embodiments.

Each of the set-up linkages 126 is configured to selectively positionand orient the associated manipulator 82 relative to the orientingplatform 124 via relative movement between links of the set-up linkage126 along multiple set-up joint (SUJ) axes. Each of the first set-uplinkage joint 84 is operable to selectively orient the associated set-uplinkage base link 100 relative to the orienting platform 124 around afirst SUJ axis 150, which in many embodiments is vertically oriented.Each of the set-up linkage extension links 102 can be selectivelyrepositioned relative to the associated set-up linkage base link 10along a second SUJ axis 152, which is horizontally oriented in manyembodiments. Each of the set-up linkage vertical links 106 can beselectively repositioned relative to the associated set-up linkageextension link 102 along a third SUJ axis 154, which is verticallyoriented in many embodiments. Each of the second set-up linkage joints108 is operable to selectively orient the mechanism support link 128relative to the set-up linkage vertical link 106 around the third SUJaxis 154. Each of the joints 132 is operable to rotate the associatedmanipulator 82 around the associated axis 138.

FIG. 7 illustrates rotational orientation limits of the set-up linkages126 relative to the orienting platform 124, in accordance with manyembodiments. Each of the set-up linkages 126 is shown in a clockwiselimit orientation relative to the orienting platform 124. Acorresponding counter-clockwise limit orientation is represented by amirror image of FIG. 7 relative to a vertically-oriented minor plane. Asillustrated, each of the two inner set-up linkages 126 can be orientedfrom 5 degrees from a vertical reference 156 in one direction to 75degrees from the vertical reference 156 in the opposite direction. Andas illustrated, each of the two outer set-up linkages can be orientedfrom 15 degrees to 95 degrees from the vertical reference 156 in acorresponding direction.

FIG. 8 shows a center of gravity diagram associated with a rotationallimit of a support linkage for a robotic surgery system 160, inaccordance with many embodiments. With components of the robotic surgerysystem 160 positioned and oriented to shift the center-of-gravity 162 ofthe robotic surgery system 160 to a maximum extent to one side relativeto a support linkage 164 of the surgery system 160, a shoulder joint ofthe support linkage 164 can be configured to limit rotation of thesupport structure 164 around a set-up structure (SUS) shoulder-jointaxis 166 to prevent exceeding a predetermined stability limit of themounting base.

FIG. 9 illustrates another approach for the implementation of aredundant axis that passes through the remote center of manipulation(RC) and the associated redundant mechanical degree of freedom. FIG. 9shows a remote center manipulator 260, in accordance with manyembodiments, that includes a mounting base 262 that includes a curvedfeature 264 having a constant radius of curvature relative to the remotecenter of manipulation (RC) and along which a base link 266 of theoutboard (proximal) linkage of the manipulator 260 can be repositioned.The outboard linkage is mounted to the base link 266, which includes a“yaw” joint feature, for rotation about a first axis 268 that intersectsthe remote center of manipulation (RC). The base link 266 is interfacedwith the curved feature 264 such that the base link 266 is constrainedto be selectively repositioned along the curved feature 264, therebymaintaining the position of the remote center of manipulation (RC)relative to the mounting base 262, which is held in a fixed positionrelative to the patient. The curved feature 264 is configured such thatmovement of the base link 266 is limited to rotation about a second axis270 that intersects the remote center of manipulation (RC). By changingthe position of the base link 266 along the curved feature 264, theorientation of the outboard linkage of the manipulator 260 relative tothe patient can be varied, thereby providing for increased range ofmotion of the surgical instrument manipulated by the remote centermanipulator 260. Parallelogram mechanism 272 provides rotation aroundaxis 274. It can be seen that as the entire parallelogram mechanismrotates around axis 268, axes 270 and 274 can be made coincident.

FIG. 10 illustrates another approach for the implementation of aredundant axis that passes through the remote center of manipulation(RC), providing an associated redundant degree of freedom. FIG. 10 showsa remote center manipulator 280, in accordance with many embodiments,that includes a mounting base 282 that includes a closed-loop curvedfeature 284 inside which a base link 286 of the outboard (distal)linkage of the manipulator 280 can be repositioned. As shown, centralmount element 285 rotates inside closed-loop curved feature 284. Baselink 286 is mounted on the central mount element 285 to be orientedsomewhat inward toward the remote center of manipulation. The outboardlinkage is mounted to the base link 286 for rotation about a first axis288 that intersects the remote center of manipulation (RC). Theclosed-loop curved feature 284 is configured such that, for allpositions of the base link 286 around the curved feature 284, theposition of the remote center of manipulation (RC) remains fixedrelative to the mounting base 282, which is held fixed relative to thepatient. The closed-loop curved feature 284 is circular and isaxially-symmetric about a second axis 290 that intersects the remotecenter of manipulation (RC). By changing the position of the base link286 around the closed-loop curved feature 284, the orientation of theoutboard linkage of the manipulator 280 relative to the patient can bevaried, thereby providing for increased range of motion, arm-to-arm orarm-to-environment collision avoidance, and/or kinematic singularityavoidance for the remote center manipulator 280. A “partial circle”feature or a full circular feature where the mounting base onlytraverses a portion of the circle can also be used. It can be seen thatcurved feature 284 and its associated central mount feature 285 act as aconical sweep joint.

FIG. 11 is a side view of the remote center manipulator 320 in which theinstrument holder 342 is pitched back to a maximum amount. In theconfiguration shown, the first parallelogram link 330 has been swung toa position just past being aligned with the extension link 324 and thesecond parallelogram link 336 has been swung to a position just pastbeing aligned with the first parallelogram link 330, thereby orientingthe insertion axis 366 to an angular offset of 75 degrees from aperpendicular 374 to the yaw axis 348. While the remote centermanipulator 320 can be configured to achieve even greater maximum pitchback angle, for example, by increasing the length of the extension link324 such that the instrument holder 342 does not come into contact withthe yaw/pitch housing 346, the additional pitch back angle gained maynot be of practical value given that the kinematics of the remote centermanipulator 320 with regard to yawing of the instrument holder 342relative to the remote center of manipulation (RC) becomes increasinglypoorly conditioned when the angle between the insertion axis 366 and theyaw axis 348 is reduced below 15 degrees.

FIG. 12 is a perspective view of one embodiment of a portion of therobotic surgery system 140. The robotic surgery system includes theorienting platform 124 with a single set-up linkage 126 attached to theorienting platform. The set-up linkage 126 includes the set-up linkagebase link 100 connected to the orienting platform 124. As seen in FIG.12, the set-up link extension link 102 slidably connects to the set-uplink base link 100. Extending vertically from the set-up link extensionlink is the set-up linkage vertical link 106 that rotatably connects tothe support link 128 via set-up linkage second joint 108. The distal endof the support link 128, with respect to the orienting platform 124 isconnected via joint 132 to the remote center manipulator 320.

Damping of Robotic Surgery Systems

In some embodiments, MIRS 10 can be damped. In some embodiments, some orall of the set-up linkages 126 of MIRS 10 are damped such thatvibrations arising in one of the set-up linkages 126 are mitigated tominimize vibration, and the therewith associated motion, in that set-uplinkage 126. Additionally, in some embodiments, a vibration arising inone or more of the set-up linkages 126 may travel from the source of thevibration in the one or more set-up linkages 126 to others of the set-uplinkages 126. This can result in a vibration arising in one or more ofthe set-up linkages 126 causing a vibration in some or all of the otherset-up linkages, which can degrade the performance of MIRS 10.

In one embodiment, the set-up linkages can be vibrationally isolatedfrom each other by one or several dampers. These one or several damperscan minimize vibration in a set-up linkage 126, which vibration arisesin another set-up linkage 126. In some embodiments, these one or severaldampers can be passive In some embodiments, one or several sensors onone set-up linkage 126 can measure a locally experienced vibrationarising due to a motion, acceleration, or vibration of another set-uplinkage 126, and can use this data to damp the locally experiencedvibration.

FIG. 13 is a section view of one embodiment of portions of the set-uplinkage 126 shown in FIG. 12. As seen in FIG. 13, the set-up linkagevertical link 106 has an internal volume 1302. In some embodiments, theinternal volume 1302 of the set-up linkage vertical link 106 cancomprise a variety of shapes and sizes. In the embodiment depicted inFIG. 13, the internal volume 1302 contains a damper 1304 that can beattached at one end to the set-up linkage vertical link 106 and at theother end to the support link 128. Damper 1304 can comprise a variety ofshapes, sizes, and designs. In some embodiments, damper 1304 can be madefrom a variety of materials and/or components. In some embodiments,damper 1304 can be configured to damp along any desired number ofdegrees of freedom (DOF). In one embodiment, for example, the damper1304 can be configured to damp along 1 DOF, 2 DOF, 3 DOF, 4 DOF, 5 DOF,6 DOF, or along any other number or combination of DOFs. The damper 1304can be configured to provide any desired level of damping. In someembodiments, the desired level of damping can be selected based on thedesired frequency and magnitude of expected vibrations to be damped.Different example embodiments of the damper 1304 are depicted in FIGS.14-18, and are identified as dampers 1400, 1500, 1600, 1700, and 1800.

FIG. 14 is a perspective view of one example embodiment of a damper1400. The damper 1400 comprises a damping platform that can be a 3 DOFdamping platform, and specifically, 3 DOF torsional/bending flexure andthree links. The damper 1400 has a top plate 1402 having a top surface1404 and a bottom surface 1405 opposite the top surface, and a bottomplate 1406 having a bottom surface 1408 and a top surface 1409 oppositethe bottom surface 1406. In the embodiment depicted in FIG. 14, both thetop plate 1402 and the bottom plate 1406 comprise cylindrical members,but in some embodiments, these plates 1402, 1406 can comprise any otherdesired shape or form. The plates 1402, 1406 can be made of a variety ofmaterials. In some embodiments, the plates 1402, 1406 can be made from arigid material and in some embodiments, the plates 1402, 1406 can bemade from a flexible material.

In some embodiments, and as depicted in FIG. 13, the top plate 1402 andthe bottom plate 1406 can be configured to mate with and/or mechanicallyconnect with portions of the set-up linkage 126. In one particularembodiment, the top plate 1402, and specifically the top surface 1404 ofthe top plate 1402 can rigidly connect to a portion of the set-uplinkage vertical link 106 and the bottom plate 1406, and particularlythe bottom surface 1408 of the bottom plate 1406 can rigidly connect tothe support link 128.

The top plate 1402 and the bottom plate 1406 are connected by a flexure,and specifically by an torsional/bending flexure 1410. Thetorsional/bending flexure 1410 can be connected to any portion of one orboth of the plates 1402, 1406, and in some embodiments, can be rigidlyconnected to both plates 1402, 1406. In the embodiment depicted in FIG.14, the torsional/bending flexure 1410 is rigidly connected to thecenter of the bottom surface 1405 of the top plate 1402 and to thecenter of the top surface 1409 of the bottom plate 1406. This connectionto the center of the plates 1402, 1406 is indicated by axis 1412 thatextends through the torsional/bending flexure 1410 and through theplates 1402, 1406.

The torsional/bending flexure 1410 can comprise a variety of shapes andsizes. In some example embodiments, the torsional/bending flexure 1410can comprise a cylindrical member, a triangular prism, a rectangularprism, a pentagonal prism, a hexagonal prism, or any other desired shapeor combination of shapes. In the embodiment depicted in FIG. 14, thetorsional/bending member comprises a first portion 1414 nearest the topplate 1402 and a second portion 1416 nearest the bottom plate 1406. Inthe embodiment of FIG. 14, the first portion 1414 comprises a cylinderhaving a radius R1 and the second portion 1416 comprises the top half ofa hyperboloid of one sheet.

The torsional/bending flexure 1410 can be made from a variety ofmaterials. In some embodiments, the torsional/bending flexure 1410 cancomprise a material that is deforms elastically over the range ofapplied forces from the robotic surgery system 140. In some embodiments,this elastic deformation results in the generation of a restorativeforce, which can move the flexure 1410 to an undeflected position afterthe applied force terminates. In some embodiments, the axial flexure1410 can comprise an elastomeric material, a rubber, metal such as, forexample, steel, aluminum, titanium, or the like, or any other elasticmaterial.

In some embodiments, the damper 1400 can comprise one or several mounts1418 that can be located on one or both of the plates 1402, 1406. In theembodiment depicted in FIG. 14, the damper 1400 comprises three mounts1418 located on, and arranged around the perimeter of, the bottomsurface 1405 of the top plate 1402 and three mounts 1418 located on, andarranged around the perimeter of, the top surface 1409 of the bottomplate 1406. The mounts 1418 can connect one or several damping units1420 to one or both of the plates 1402, 1406. In some embodiments, themounts 1418 can comprise a 3-DOF mounts. In one embodiment, the mounts1418 can comprise 3-DOF ball joint mounts, and in one embodiment, themounts 1418 can comprise a 2-DOF U-joint mounted on a 1-DOF rotary base.In one embodiment, the 1-DOF rotary base can be mounted to rotate aboutan axis parallel to axis 1412 shown in FIG. 14.

The damping units 1420 can comprise a variety of types, shapes, andsizes. In some embodiments, the damping units 1420 can be configured todamp movements of the top plate 1402 relative to the bottom plate 1406.In one embodiment, these movements can include one or several motions ofthe top plate 1402 and bottom plate 1406 with respect to each other inone or several of the six Cartesian degrees of freedom. In someembodiments, the degrees of freedom in which movements can occur, andtherefore in which movements can be damped can depend on the design ofthe specific damper. In one embodiment of the damper 1400 depicted inFIG. 14, the damper 1400 can be constrained in each of the three lineardegrees of freedom and can deflect in any of the three orthogonal rotarydegrees of freedom as indicated by pitch, roll, and yaw in that figure,and in another embodiment of the damper 1400 depicted in FIG. 14, thedamper 1400 can deflect in any of the three orthogonal rotary degrees offreedom and in any of the three linear degrees of freedom. In someembodiments, embodiments, roll indicated in FIG. 14 can correspond totorsion, and pitch and/or yaw indicated in FIG. 14 can correspond tobending. In one embodiment, the damping units 1420 can comprisehydraulic shock absorbers, magnetic shock absorbers, pneumatic shockabsorbers, or any other kind of passive shock absorber.

FIG. 15 is a perspective view of one embodiment of a damper 1500, whichdamper 1500 can be a damping platform such as 3 DOF damping platform,and specifically can be a hexapod. The damper 1500 of FIG. 15 includes atop plate 1502 having a top surface 1504 and a reverse bottom surface1505, and a bottom plate 1506 having a bottom surface 1508 and a reversetop surface 1509. The plates 1502, 1506 can be the same or differentthan the plates 1402, 1406 disclosed above. In some embodiments, damper1500 can be constrained in each of the three linear degrees of freedomand can deflect in any of the three orthogonal rotary degrees offreedom.

The top plate 1502 and the bottom plate 1510 can be connected by ashaft, and specifically by axial shaft 1510. As seen in FIG. 15, theaxial shaft 1510 can connect to the top plate 1502 via a ball joint 1512that can allow angular and rotational movement of the top plate 1502with respect to the bottom plate 1506. In some embodiments, the axialshaft 1510 can connect to the bottom plate via a ball joint similar toball joint 1512, and in some embodiments, the axial shaft 1510 canrigidly connect to the bottom plate 1506, and in one embodiment, can becantilevered from the bottom plate 1506.

The shaft 1510 can comprise a variety of shapes and sizes and can bemade from a variety of materials. In some embodiments, the axial shaft1510 can be sized and shaped, and made from a material to withstand theforces applied to it during the damping of vibrations arising from themovement of portions of the robotic surgery system 140. In someembodiments, the axial shaft 1510, and particularly in the embodiment ofFIG. 15, the axial shaft can comprise a rigid member.

In some embodiments, the top and bottom plates 1502, 1506 can include aplurality of mounts 1514 that can connect one or several damping systems1515 to the top and bottom plates 1502, 1506. In some embodiments, thesemount 1514 can comprise 3-DOF mounts similar to those disclosed withrespect to FIG. 14. In some embodiments, the damping system 1515 can beconfigured to damp motion and well as provide a restorative force inresponse to a motion damped by the damping system 1515. In theembodiment of FIG. 15, the damping system 1515 comprises a damping unit1516 having the same or different properties and attributes as thedamping unit 1420 of FIG. 14, and one or several springs 1518 associatedwith one or several damping units 1516. In one embodiment, a spring 1518can be uniquely associated with each damping unit 1516 of the dampingsystem 1515. In some embodiments, the spring 1518 associated with thedamping unit 1516 can be positioned proximate to the damping unit 1516,and in some embodiments, the spring 1518 and the damping unit 1516 canbe integrated into a combined damping system 1515, such as, for example,the coil-over springs shown in FIG. 15.

The damper 1500 can comprise any desired number of damping systems 1515.In some embodiments, the damper 1400 can comprise 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 15, 20, 30, 50, 100, and/or any other or intermediate numberof damping systems 1515, damping units 1516, and/or springs 1518.

FIG. 16 is a perspective view of one embodiment of a damper 1600.Similar to damper 1400, damper 1600 includes a top plate 1602 having atop surface 1604 and a reverse bottom surface 1605, and a bottom plate1606 having a bottom surface 1608 and a reverse a top surface 1609. Thetop and bottom plates 1602. 1606 can be connected, at least in part, byan axial flexure 1610 that can extend along axis 1612.

In the embodiment depicted in FIG. 16, the top plate 1602 and the bottomplate 1606 can be separated by a middle plate 1614 that can have a topsurface 1616 and a bottom surface 1618. The middle plate 1614 can bemade of the same or different materials than one or both of the top andbottom plates 1602, 1606. In the embodiment of FIG. 16, the axialflexure 1610 can extend from the top surface 1609 of the bottom plate1606 to the bottom surface 1618 of the middle plate 1614, which middleplate 1614 can be connected to the top plate 1602 via radial structure1620, also referred to herein as a radial flexure, made of one or morevertical walls 1622 or other structure that extend outward from a centerlocation. In some embodiments, the radial structure 1620 can beconfigured to deflect in response to a torsional force around thedamper's longitudinal axis (axial torsion) applied to one or both of thetop plate 1602 and the bottom plate 1606. In some embodiments, thevertical walls 1622 of the radial structure 1620 can be made of anelastically deformable material to allow the deformation of the radialstructure 1620 in response to these applied forces, and in someembodiments, the vertical walls 1622 can be arranged to create one orseveral shapes such as, for example, a cross/cruciform, an x-shape, ay-shape, a five-spoke shape, and the like, as seen in plane extendingthrough the radial structure 1620 between the top plate 1602 and themiddle plate 1614.

The damper 1600 can include a plurality of mounts 1624 that can locatedon and/or attached to one or both of the bottom plate 1606 and themiddle plate 1614. In some embodiments, these mounts 1624 can be used toconnect one or several damping units 1626 to one or both of the bottomplate 1606 and the middle plate 1614. These mounts 1624 can comprise3-DOF mounts similar to those disclosed above with respect to FIG. 14.Thus, as shown in FIG. 16 the bottom portion of damper 1600 may beoptionally configured as generally described above for damper 1400 (FIG.14), or it may be optionally configured as shown for other dampers suchas damper 1500 (FIG. 15).

FIG. 17 is a perspective view of one embodiment of a damper 1700.Similar to damper 1600, damper 1700 includes a top plate 1702 having atop surface 1704 and a reverse bottom surface 1705, and a bottom plate1706 having a bottom surface 1708 and a reverse top surface 1709. Thetop and bottom plates 1702. 1706 can be connected, at least in part, byan axial flexure 1710 that can extend along axis 1712.

In the embodiment depicted in FIG. 17, the top plate 1702 and the bottomplate 1706 can be separated by a middle plate 1714 that can have a topsurface 1716 and a bottom surface 1718. The middle plate 1714 can bemade of the same or different materials than one or both of the top andbottom plates 1702, 1706. In the embodiment of FIG. 17, the flexure 1710can extend from the top surface 1709 of the bottom plate 1706 to thebottom surface 1718 of the middle plate 1714. In some embodiments, thebendability and elasticity of the axial flexure 1710 can be improved bythe inclusion of a decoupling flexure 1711 positioned between the axialflexure 1710 and the middle plate 1714. In the embodiment depicted inFIG. 17, the decoupling flexure 1711 comprises void 1713 within themiddle plate 1714. The void 1713 is defined by a thin plate 1715 locatedproximate to the bottom surface 1718 of the middle plate 1714, a voidtop surface 1717 positioned opposite the thin plate 1715, and aperimeter side wall 1719 that extends around all or a portion of theperimeter of the void 1711 and connects the thin plate 1715 to the voidtop surface 1717. As seen in FIG. 17, the axial flexure 1710 connectswith the middle plate 1714 via the thin plate 1715. In some embodiments,the void 1713 can increase the ability of the damper 1700 to dampvibrations/movements along one or several Cartesian degrees of freedom.In the embodiment depicted in FIG. 17, for example, the void 1713 mayallow a linear displacement of the middle plate 1714 with respect to thebottom plate 1706 along longitudinal axis 1712. Further, the void 1713may allow rotations of the middle plate 1714 with respect to the bottomplate 1706 about axes perpendicular to the longitudinal axis 1712.

In some embodiments, the middle plate 1714 can be connected to the topplate 1702 via radial structure 1720 made of one or more vertical walls1722 or other structure that extend outward from a center location. Insome embodiments, the radial structure 1720 can be configured to deflectin response to a torsional force around the damper's longitudinal axis(axial torsion) applied to one or both of the top plate 1702 and thebottom plate 1706. In some embodiments, the vertical walls 1722 of theradial structure 1720 can be made of an elastically deformable materialto allow the deformation of the radial structure 1720 in response tothese applied forces, and in some embodiments, the vertical walls 1722can be arranged to create one or several shapes such as, for example, across/cruciform, a x-shape, a y-shape, a five-spoke shape, and the like,as seen in plane extending through the radial structure 1720 between thetop plate 1702 and the middle plate 1714.

The damper 1700 can include a plurality of mounts 1724 that can locatedon and/or attached to one or both of the bottom plate 1706 and themiddle plate 1714. In some embodiments, these mounts 1724 can be used toconnect one or several damping units 1726 to one or both of the bottomplate 1706 and the middle plate 1714. These mounts 1724 can comprise3-DOF mounts similar to those disclosed above with respect to FIG. 14.

FIG. 18 is a section view of one embodiment of a damper 1800, andspecifically of an interdigitated damper. The damper 1800 includes afirst piece 1802. The first piece 1802 can comprise a variety of shapesand sizes, and can be made from a variety of materials. In someembodiments, the first piece 1802 can be made of a material, and sizedand shaped so as to be rigid for the loads applied to the damper 1800.

The first piece 1800, also referred to herein as an insert, can includea top plate 1804 having a top surface 1806 and a reverse bottom surface1807. The first piece 1802 can further include a bottom surface 1808located at the opposite end of the first piece 1802 as compared to thetop surface 1806 of the top plate 1804.

As seen in FIG. 18, a longitudinal axis 1810 can extend through thecenter of the first piece 1802 between the top surface 1806 of the topplate 1804 and the bottom surface 1808 of the first piece 1802. Thefirst piece can include a shaft 1812 that extends along the longitudinalaxis 1810 and from the bottom surface 1807 of the top plate 1804 to thebottom surface 1808 of the first piece 1802. This shaft 1812 cancomprise an elongate member that can be the same, or different materialthan the other portions of the first piece 1802.

In some embodiments, one or several protrusions 1814 can extend awayfrom the shaft 1812. In some embodiments, these protrusions 1814 can beregularly or irregularly spaced along the length of the shaft 1812, aswell as regularly or irregularly spaced around the perimeter of theshaft 1812. The protrusions 1814 can each comprise a variety of shapesand sizes. In one embodiment, the protrusions 1814 can comprise adisk-shaped member radially extending from the either some or all of theperimeter of the shaft 1812. In some embodiments, the first piece 1802can include 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, and/or any other orintermediate number of protrusions 1814.

The damper 1800 can include a second piece 1820, also referred to hereinas a cup, that can be sized and shaped to receive some or all of thefirst piece 1802. The second piece 1820 can comprise a variety of shapesand sizes, and can be made from a variety of materials. In someembodiments, the second piece 1820 can be made of a material, and sizedand shaped so as to be rigid for the loads applied to the damper 1800.

The second piece 1820 can include a top surface 1822, a reverse bottomsurface 1824, and a side wall 1826 extending from the top surface 1822to the bottom surface 1824 of the second piece 1820. In someembodiments, the side wall 1826 can include an interior wall 1828. Inthe embodiment depicted in FIG. 18, the combination of the top andbottom surfaces 1822, 1824 and the interior wall 1828 can bound and/orpartially bound an internal volume 1829 of the second piece 1820. Insome embodiments, the internal volume 1829 of the second piece 1820 canreceive some or all of the first piece 1802, and as depicted in FIG. 18,the internal volume 1829 can receive the shaft 1812 and the protrusions1814 of the first piece 1802.

As seen in FIG. 18, in some embodiments, one or several matingprotrusions 1830 can extend from the interior wall 1828 of the secondpiece 1820 towards the longitudinal axis 1810. In some embodiments,these mating protrusions 1830 can be regularly or irregularly spacedalong the length of the interior wall 1828, as well as regularly orirregularly spaced around the perimeter of the interior wall. The matingprotrusions 1830 can comprise a variety of shapes and sizes. In oneembodiment, the mating protrusions 1830 can each comprise anannular-shaped member extending radially inward from the either some orall of the perimeter of the interior wall 1828. In some embodiments, thesecond piece 1820 can include 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20,and/or any other or intermediate number of mating protrusions 1830.

In some embodiments, and as depicted in FIG. 18, the protrusions 1814and the mating protrusions 1830 can be positioned such that some or allof the mating protrusions 1830 extend between pairs of protrusions 1814.Similarly, in some embodiments, the protrusions 1814 and the matingprotrusions 1830 can be sized and shaped such that when the first piece1802 is received within the internal volume 1829 of the second piece1820, the protrusions 1814 and the mating protrusions 1830 areinterdigitated and that such that a film space 1832 exists between theprotrusions and the mating protrusions 1830. In some embodiments, thefilm space 1832 can be filled with a material that can be a fluid orfluid like substance, such as powder. In some embodiments, the fluid cancomprise a viscous fluid and/or a highly viscous fluid. In someembodiments, the fluid can have a viscosity of at least 20 centipoise,50 centipoise, 100 centipoise, 200 centipoise, 500 centipoise, 1000centipoise, 1500 centipoise, 2000 centipoise, and/or of any other orintermediate value. In some embodiments, a fluid is a highly viscousfluid when it has a viscosity of at least 200 centipoise. In someembodiments, the material in the film space can be selected to providethe desired damping level in the damper 1800. In some embodiments, andas seen in FIG. 18, the film space 1832 can be sealed by, for example,seal 1834. The seal 1834 can be any type of seal including, for example,a gasket, an O-ring, or the like.

In some embodiments, a spring can extend from the first piece 1802 tothe second piece 1820. In some embodiments, the spring can be configuredto apply a restorative force to the first and second pieces 1802, 1820after they have been moved relative to each other. In some embodiments,the spring can be a 1 DOF spring, a 2 DOF spring, a 3 DOF spring, a 4DOF spring, a 5 DOF spring, a 6 DOF spring, or a spring active along anyother number or combination of DOFs. In one embodiment, the spring canbe a torsion spring, a compression spring, a tension spring, or anyother kind of spring. The spring can comprise any desired shape andsize, and can be made from any desired material. In some embodiments,the spring can be designed so as to provide a desired strength ofrestorative force to the first and second pieces 1802, 1820.

Other variations are within the spirit of the present invention. Thus,while the invention is susceptible to various modifications andalternative constructions, certain illustrated embodiments thereof areshown in the drawings and have been described above in detail. It shouldbe understood, however, that there is no intention to limit theinvention to the specific form or forms disclosed, but on the contrary,the intention is to cover all modifications, alternative constructions,and equivalents falling within the spirit and scope of the invention, asdefined in the appended claims.

The use of the terms “a” and “an” and “the” and similar referents in thecontext of describing the invention (especially in the context of thefollowing claims) are to be construed to cover both the singular and theplural, unless otherwise indicated herein or clearly contradicted bycontext. The terms “comprising,” “having,” “including,” and “containing”are to be construed as open-ended terms (i.e., meaning “including, butnot limited to,”) unless otherwise noted. The term “connected” is to beconstrued as partly or wholly contained within, attached to, or joinedtogether, even if there is something intervening. Recitation of rangesof values herein are merely intended to serve as a shorthand method ofreferring individually to each separate value falling within the range,unless otherwise indicated herein, and each separate value isincorporated into the specification as if it were individually recitedherein. All methods described herein can be performed in any suitableorder unless otherwise indicated herein or otherwise clearlycontradicted by context. The use of any and all examples, or exemplarylanguage (e.g., “such as”) provided herein, is intended merely to betterilluminate embodiments of the invention and does not pose a limitationon the scope of the invention unless otherwise claimed. No language inthe specification should be construed as indicating any non-claimedelement as essential to the practice of the invention.

Preferred embodiments of this invention are described herein, includingthe best mode known to the inventors for carrying out the invention.Variations of those preferred embodiments may become apparent to thoseof ordinary skill in the art upon reading the foregoing description. Theinventors expect skilled artisans to employ such variations asappropriate, and the inventors intend for the invention to be practicedotherwise than as specifically described herein. Accordingly, thisinvention includes all modifications and equivalents of the subjectmatter recited in the claims appended hereto as permitted by applicablelaw. Moreover, any combination of the above-described elements in allpossible variations thereof is encompassed by the invention unlessotherwise indicated herein or otherwise clearly contradicted by context.

All references, including publications, patent applications, andpatents, cited herein are hereby incorporated by reference to the sameextent as if each reference were individually and specifically indicatedto be incorporated by reference and were set forth in its entiretyherein.

What is claimed is:
 1. A surgical system comprising: a base; a firstlink mechanically coupled to the base; a second link mechanicallycoupled to the first link at a damper; and a surgical tool supported bythe second link.
 2. The surgical system of claim 1, wherein the dampercomprises a spring element and a damping element.
 3. The surgical systemof claim 1, wherein the damper comprises a damping platform having atleast 3 mechanical degrees of freedom.
 4. The surgical system of claim3, wherein the at least 3 mechanical degrees of freedom include: arotational degree of freedom about an axis; a pitch degree of freedomrelative to the axis; and a yaw degree of freedom relative to the axis.5. The surgical system of claim 1, wherein the damper comprises a topplate and a bottom plate, the top plate and the bottom plate beingconnected by an axial flexure and a plurality of damping elementsradially positioned around the axial flexure.
 6. The surgical system ofclaim 5, wherein the axial flexure is of cylindrical shape.
 7. Thesurgical system of claim 5, wherein the axial flexure comprises anon-constant radius between the portion of the axial flexure connectingto the top plate and the portion of the axial flexure connecting to thebottom plate.
 8. The surgical system of claim 7, wherein the radius ofthe portion of the axial flexure connecting to the top plate is largerthan the radius of the portion of the axial flexure connecting to thebottom plate.
 9. The surgical system of claim 5, further comprising aradial flexure coupled to the top plate of the damper.
 10. The surgicalsystem of claim 9, further comprising a decoupling flexure positionedbetween the axial flexure and the radial flexure.
 11. The surgicalsystem of claim 1, wherein the damper comprises a top plate and a bottomplate connected by a shaft, the shaft being connected to the top plateby a ball pivot.
 12. The surgical system of claim 11, wherein the damperfurther comprises a plurality of damping elements radially positionedaround the shaft.
 13. The surgical system of claim 12, wherein at leastone of the plurality of damping elements is paired with a spring. 14.The surgical system of claim 12, wherein at least one of the pluralityof damping elements comprises a coil-over damper.
 15. The surgicalsystem of claim 1, wherein the damper comprises a squeeze film damper.16. The surgical system of claim 15, wherein the squeeze film dampercomprises a cup, an insert, and a damping fluid between the cup and theinsert.
 17. The surgical system of claim 16, wherein the cup comprises aplurality of inwardly extending ridges, and the insert comprises aplurality of outwardly extending ridges.
 18. The surgical system ofclaim 17, wherein the plurality of inwardly extending ridges areinterdigitated with the plurality of outwardly extending ridges.
 19. Thesurgical system of claim 15, wherein the squeeze film damper has atleast 3 mechanical degrees of freedom.
 20. The surgical system of claim19, wherein the at least 3 mechanical degrees of freedom include: arotational degree of freedom about an axis; a pitch degree of freedomrelative to the axis; and a yaw degree of freedom relative to the axis.21. A method of controlling a movement of a surgical system, the methodcomprising: automatically damping a vibration of the surgical system,the vibration resulting from a movement of a first portion of thesurgical system; and commanding a movement of a surgical tool coupled toa second portion of the surgical system.
 22. The method of claim 21,wherein the first portion comprises a first set-up linkage, and thesecond portion comprises a second set-up linkage.
 23. The method ofclaim 21, wherein the surgical system comprises a computer-assistedteleoperated surgical system, and the movement of the first portion ofthe surgical system is a teleoperated movement of the surgical system inresponse to a movement of an input control device.